• Curr Med Res Opin · Jul 2022

    Treatment persistence and maintenance dose titration among ulcerative colitis on biologics: a pooled study of three United States claim databases.

    • Janvi Sah, Amanda Teeple, Erik Muser, Cynthia Gutierrez, and Themistocles Dassopoulos.
    • STATinMED Research, HEOR, Ann Arbor, MI, USA.
    • Curr Med Res Opin. 2022 Jul 1; 38 (7): 1093-1101.

    ObjectiveThis real-world study evaluated biologic treatment patterns in patients with moderate-to-severe ulcerative colitis (UC).MethodsIQVIA PharMetrics, IBM MarketScan, and Optum Clinformatics were pooled to identify UC patients with ≥1 claim for UC and ≥1 claim for adalimumab (ADA), golimumab (GOL), infliximab (IFX), or vedolizumab (VDZ). The index date for each biologic was the first claim for that biologic. Patients could be included in >1 cohort if they switched biologics during the identification period. Continuous eligibility for medical/pharmacy benefits was required for 12 months before (baseline) and after (follow-up) the index date. Patients lacking claims for any biologic during baseline were categorized as bio-naïve; those with any biologic claim were categorized as bio-experienced. Persistence was defined as the proportion of patients that remained on the index biologic without a gap between claims of >28 days for ADA, >56 days for GOL, and >112 days for IFX and VDZ. Dose titration was assessed among patients with ≥2 maintenance doses during follow-up among ADA, GOL, and VDZ patients.ResultsIn total, 6,106 bio-naïve UC patients and 1,027 bio-experienced UC patients were identified. Patients treated with VDZ and IFX had the highest persistence followed by ADA and GOL patients for bio-naïve and bio-experienced, respectively. ADA patients had a numerically higher proportion of patients with 50% dose escalation, followed by VDZ and GOL; 50% dose reduction was observed in ≤1% patients.ConclusionsIn this descriptive study of UC patients without confounder adjustment, VDZ persistence was numerically highest followed by IFX, GOL, and ADA across both populations.

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